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The Lawyered Up: Challenging Patients You’ve Known Well, Part 2

Patients Who Lawyer Up

 “We live in a litigious society.” You hear that statement bandied about quite a bit, and if you watch much late night television, you might begin to believe it based on the number of law firms trolling for potential litigants in class action suits. In fact, the opposite is true, at least when it comes to medical malpractice cases. Medical malpractice lawsuits are down across the country, according to Michael Matray, editor of Medical Liability Monitor. Good news, unless you have one of “those” patients, the type that threatens to sue if they don’t receive immediate attention or a preferred appointment time isn’t available.  Maybe what you need isn’t your own attorney on speed dial, but insights into patients who are more inclined to cry foul when it comes to their healthcare providers.  This isn’t about avoiding care for these patients; it’s about understanding their motivations to deliver service they define as excellent.

Let’s take a look at how psychographic segmentation can help. Recall from earlier posts, psychographic segmentation involves grouping patients according to shared values, personalities, and motivations. Each psychographic segment has its own communication preferences.

Tips for Managing the Challenging Patient

Unless you’re extremely fortunate, you’ve probably experienced your share of difficult patients. One recent American Academy of Orthopedic Surgeons’ blog declared “Difficult patients are dependent, clingy, and entitled at best; they may also be manipulative, self-destructive, noncompliant, litigious and even hostile.” That’s quite a litany of faults. Fortunately, the post went on to offer three tactics for dealing with the curmudgeons and worse.

  1. Work on your communication skills. Are you listening? Are you showing empathy? Are you explaining adequately? Are you using the words that appeal to that patient’s specific psychographic segment? Should you find yourself working with a difficult patient, take a step back and evaluate whether you need to slow down to create a more satisfying patient experience—an extra 10 minutes could make a big difference.  This isn’t feasible for all patients, but for the few that require the added attention, the investment can be worth it.
  2. Set boundaries. Patients who don’t know where they stand are more likely to try to cross the line. By setting standards or limits for how your organization services patients and publicizing it widely, helps staff avoid getting into emotionally-charged disputes by referring to the policy, designed to address the needs of all valued patients.
  3. Let the patient go. It’s certainly not the best choice, but as the American Medical Association has noted, “Physicians have an obligation to support continuity of care for their patients. Physicians do have the option of withdrawing from a case, but they cannot do so without giving notice to the patient, the relatives, or responsible friends, which allows the patient sufficient time to secure further care.” Be aware that a spurned patient may lash out. Before the digital age, that might have just meant complaining to friends and family, but these days, it could result in online reviews and social media posts that go viral. Moreover, certain psychographic segments are more likely to use social media in this way than others.

The Lawyered-up Patient Psyche

While it’s possible that your litigious patient has insomnia and keeps a list of the late-night lawyers, there’s another more likely explanation: Your patient could have deep-seated attitudes towards healthcare that influence how the patient experience is perceived. The proprietary psychographic segmentation model developed by c2b solutions classifies patients into five distinct segments:

  1. Balance Seekers represent 18 percent of the patient population. They consider healthcare professionals to be useful resources for leading a healthy life, but are open to alternate sources of information.
  2. Willful Endurers represent 27 percent of the patient population. They live in the here and now, are very self-reliant and call on a physician only when it is a necessity.
  3. Priority Jugglers, as you might imagine, find themselves stretched thin due to their many responsibilities. Like Balance Seekers, they represent 18 percent of the patient population. They may put off managing their own health needs but are quite proactive when it comes to managing the health needs of their loved ones.
  4. Self Achievers represent 24 percent of the patient population. They are proactive, goal-oriented and motivated to stay on top of health issues.
  5. Direction Takers represent 13 percent of the patient population. As their moniker suggests, they look to healthcare professionals as the most trusted resource for healthcare needs. As a result, they tend to call the doctor for any health concern, but despite the best intentions, they do not always follow medical advice.

Based on those descriptions, you may already be able to envision some of your more problematic patients, especially the litigious ones.

The c2b Consumer Diagnostic, c2b solutions’ national study of healthcare consumers, included litigation risk among the many topics it covered.  It found that certain psychographic segments were statistically more likely to indicate that they would sue a healthcare provider if they did not receive the expected services:


Note: Each c2b Psychographic Segment has a letter, a-e, associated with it in the table above.  If the letter appears below a percentage, then that percentage is statistically greater than the percentage in the column with the corresponding letter.  For example, 15% of Willful Endurers (column b) indicated that they are Extremely/Very Likely to sue a hospital, which is statistically greater (95% confidence) than all other segments (columns a, c, d and e).

In fact, the Willful Endurer segment is more likely than all other segments to file a lawsuit against physicians and health insurance companies, too.  Clearly, it is important to understand how this patient type is hardwired and how to provide a superior level of service according to his/her expectations.

However, it is not only the Willful Endurer segment that represents a litigation risk; any patient can pursue legal action if he/she perceives suboptimal care.

Does a long wait time during a scheduled appointment set a patient off? If so, maybe you’re dealing with a Priority Juggler. What can you do? Schedules slip depending on what you encounter throughout the day; it’s just a fact of life. But if you want to mitigate the risk of a scene at the office or a threatening letter, maybe the solution is as simple as making it a standard practice to schedule that patient for the first appointment of the day or the first appointment after lunch when the schedule is most likely to still be intact.

Do you have a patient that gets easily exasperated—and makes noises about a lawyer—because the medical advice isn’t working? If you know that you’re dealing with a Direction Taker, a conversation about challenges that patient might have with following discharge instructions—like inability to get prescriptions filled or lack of transportation for follow-up appointments—could reveal a fix that doesn’t charge $200 an hour.

The point is that psychographic segmentation helps you understand what motivates your patients when it comes to health and wellness. And once you know what’s influencing their attitudes, you may find that you do have an alternative to “firing” your problem patients.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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